Efficacy differences of biologic agents targeting different pathways in obese patients with psoriasis: a systematic review and meta-analysis.
Wenjing Zhou, Zhentao Xu, Haibo Yu et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the impact of obesity on the efficacy of biologic agents in psoriasis treatment, analyzing data from 12 studies involving 4200 patients. The study found that obese patients had a lower PASI90 response (RR = 0.64), indicating reduced efficacy of biologics, particularly IL-17 and IL-12/23 inhibitors, although publication bias was noted.
Key findings
- Obese patients had a lower PASI90 response with a relative risk of 0.64.
- Significant negative effects were observed for IL-17 inhibitors (RR = 0.57) and IL-12/23 inhibitors (RR = 0.43).
- PASI75 and PASI100 responses were also lower in obese patients, with RRs of 0.52 and 0.42, respectively.
- Heterogeneity was influenced by biologic class, study design, region, mean BMI, and obesity proportion.
Why it matters
Understanding the influence of obesity on biologic treatment efficacy in psoriasis is crucial for optimizing patient management. Clinicians should consider weight status among other factors when selecting biologic therapies, as it may affect treatment outcomes.
What to keep in mind
Publication bias was present, and the findings for some biologic classes were based on a small number of studies, limiting robustness.